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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical picture and differential diagnosis of Yersinia arthritis are shown by means of three own observations. It is an acute oligoarthritis affecting especially knee- and ankle-joints. The involved joints are very painful, swollen and warm. There may be a history of enteritis or suspicion of acute appendicitis because of lower abdominal pain, but this is not obligatory. The laboratory parameters of inflammation (ESR, C-reactive protein, white blood count, serumproteinelectrophoresis) are changed significantly. Diagnosis is made by serum agglutination reaction (Widal-reaction) against ceesurface antigens (O-antigens) of Yersinia enterocolitica. Almost only people with the HL-A antigen B27 tend to get arthritis during Yersinia infection. The differential diagnosis has to consider reactive arthritis during Salmonella or Shigella infections, acute sarcoidosis, Reiter's disease and rheumatoid arthritis.
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PMID:[Yersinia arthritis (author's transl)]. 52 13

The principal clinical syndromes caused by Yersinia (Y. pseudotuberculosis and Y. enterocolitica) are described. It is likely that they are zoonoses transmitted to man by ingestion. Fever, abdominal pain and diarrhea are the commonest symptoms, and patients are often operated upon for suspected appendicitis. The symptoms associated with these infections include arthralgia and erythema nodosum, particularly in adults. Most cases are benign, but some may be severe. Fortunately, however, many antibiotics are active against Yersinia. At present these diseases are uncommon in Switzerland but appear to be endemic in Scandinavia. Their relative incidence may increase if physicians become more aware of this possible etiology.
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PMID:[Yersinioses]. 76 81

The rate of yersiniosis in patients with acute abdominal disease was studied in a 16-month prospective investigation in 1972-1973 of 205 acutely ill patients referred to a surgical clinic of a Copenhagen City hospital with complaints of abdominal pain suggestive of appendicitis. Yersinia enterocolitica, biotype 4, was isolated from 11 patients (5.4%), 8 of whom were children. Yersinia was grown from faeces in 8 cases and from appendix of all 9 patients operated upon. Rising or falling agglutinin titres larger than or equal to 100, indicative of yersiniosis, were found in 22 patients (10.7%) including all bacteriologically verified cases. Eight additional patients (3.9%) had less significant titres larger than or equal to 100, suggestive of recent or present infection. 28 patients (13.7%) had insignificant titres, including 3 with antibodies against serotype 9. In all cases except these 3, antibodies were against Y. enterocolitica, serotype 3. A differential diagnosis between Y. enterocolitica infection and other types of appendicitis could not be made within this highly selected group of patients using available clinical data. All cases were rather mild and self-limiting. It is suggested that in future epidemiological and other studies of yersiniosis, early bacteriological and serological examinations be carried out.
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PMID:Yersinia enterocolitica infection in patients with acute surgical abdominal disease. A prospective study. 78 44

The clinical, radiological, and endoscopic aspects of Yersinia enterocolitica infections in man were studied in a group of 37 adult patients observed in a 4-year period in a single gastrointestinal unit. The diagnosis was based on isolation of the bacterium in all but 1 patient. Abdominal pain and diarrhea were the most prominent symptoms, occurring in 80% of the patients. A syndrome simulating appendicitis was observed in 40%. The duration of symptoms before diagnosis varied from 1 or 2 weeks in 32 patients to several months in 5. On radiological examination the terminal ileum was involved over a distance of 10 to 20 cm in 21 of 24 patients. A coarse, irregular, or nodular mucosal pattern and pictures suggestive of ulcerations were the most prominent and early radiological signs. Endoscopic observations in 13 patients with marked diarrhea showed signs of colitis in 6 and aphthoid ulcers in 2 patients. On pathological examination, ulcerations and a nonspecific acute inflammatory cell infiltrate were observed. Although treatment with tetracycline or chloramphenicol resulted in 4 to 6 weeks in the disappearance of most symptoms and signs, pictures of "follicular ileitis" persisted for several months.
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PMID:Yersinia enteritis and enterocolitis: gastroenterological aspects. 83 May 72

Yersinia arthritis is an acute oligo- or, more rarely, polyarthritis. It occurs after pyrexic diarrhoea of several days, often associated with right-sided lower abdominal pain. The disease is caused by Yersinia enterocolitica and four such cases, confirmed serologically in three, are described. In one case fluid from the knee-joint was antibody-positive. It was not possible to culture the causative organism, probably because all patients had previously been treated with an antibiotic. Rheumatic fever and Reiter's disease must be considered in the differential diagnosis. Because pharyngitis, transitory ECG changes and conjunctivitis may occur in the early stages of Yersinia arthritis, the diagnosis may be missed. Prognosis of Yersinia arthritis is good, with complete cure within weeks or months. Demonstration of HLA-B 27 in all four cases points to a genetic disposition.
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PMID:[Yersinia arthritis (author's transl)]. 97 16

Since Yersinia enterocolitica, now classified as a member of the Enterobacteriaceae, was recognized as a distinct species in 1964 it has been isolated with increasing frequency from man and animals (including dogs and pigs) and from some human foods. Y. enterocolitica infections are now seen as a cause for some concern in both human and veterinary medicine. The organism is commonly found in specimens from swine slaughterhouses and has been isolated from samples of market meat, vacuum-packed beef, mussels, oysters, and ice-cream. It has also been found in nonchlorinated well water used for drinking purposes. Infections in man therefore probably have an alimentary origin. Only 23 human infections were recorded in 1966 but the number increased to over 4000 in 1974. However, reported incidence is affected by growing awareness about the role of the organism in human and animal disease and by intensive laboratory analyses. While knowledge about the geographical distribution of Y. enterocolitica is still fragmentary it is clear that infections are very frequent in some parts of the world and probably common but unrecognized in many countries. The most common symptoms of Y. enterocolitica infections in man are fever, abdominal pain, and diarrhoea. In the USA most isolations in human infections were made from blood and mesenteric lymph node samples. The pathogenic mechanism is not known. In one experiment involving a human volunteer subject a dose of 3.5 x 10(9) organisms was required to produce an infection. Only recently has some success been obtained in establishing experimental infections in mice, guinea-pigs, rats, and rabbits. Laboratory cultivation techniques for Y. enterocolitica are described together with a table of minimal tests for characterizing the organism and two biotyping schema. Little is known about methods for controlling this disease, but environmental hygiene and sanitation with regard to food and water should apply.
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PMID:Yersinia enterocolitica : a review of its role in food hygiene. 108 89

74 patients, 42 females, 32 men-all over 10 years of age, with acute arthritis associated with infection with Yersinia enterocolitica are presented. The diagnosis was based on serological evidence in all cases (an agglutinin titre of 320 or more), and in 18 of the cases also a positive culture of Y. ent. from faeces. The erythrocyte sedimentation rate was very high in most cases. Acute enteritis, sometimes with abdominal pain, preceded the acute arthritis with a latent period of about 1-14 days. In 50% of the cases only one or two joints were involved, most often large joints such as knee, ankle and wrist. The symptoms were long-standing (2 months or longer) in two-thirds of the cases. Arthritis in connection with yersiniosis must therefore be considered a serious complication to an otherwise rather benign infection.
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PMID:Arthritis associated with Yersinia enterocolitica infections. 117 74

The aim of the present study was to elucidate the gastrointestinal manifestations of yersiniosis. During the period 1974 to 1983, Yersinia enterocolitica infection was diagnosed in 458 patients, by isolation from fecal samples or by antibody response. At first admission, 184 patients had abdominal pain; 200, diarrhea; 45, vomiting; and 36, weight loss. Ulcerative colitis was diagnosed in 7 patients, Crohn's disease in 2, and unspecific colitis in 11. Mesenteric lymphadenitis or ileitis were found in 43 of 56 patients at laparotomy. The patients were followed for 4 to 14 years (1987). Thirty-eight patients were readmitted with abdominal pain and 28 with diarrhea; these symptoms were significantly correlated with the corresponding symptoms at first admission. Chronic colitis was diagnosed in 4 patients, chronic weight loss in 12. A follow-up inquiry (380 patients) indicated that patients with right iliac fossa pain during the acute infection less frequently developed chronic abdominal complaints. Gastrointestinal symptoms are common in both the acute and chronic states of yersiniosis. The correlations between acute and chronic symptoms indicate that yersiniosis is a chronic disease. Immunologically competent individuals may profit by fighting the infection in the right iliac fossa. The relationship between yersiniosis and inflammatory bowel diseases may still not be settled.
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PMID:Acute and chronic gastrointestinal manifestations associated with Yersinia enterocolitica infection. A Norwegian 10-year follow-up study on 458 hospitalized patients. 154 97

The clinical data of 97 patients with Yersinia enterocolitica infection during 1989 were evaluated. The diagnosis was made by positive culture, serology and/or detection of Yersinia antigens in biopsies. The enteric form (enteritis, abdominal syndrome, pseudo-appendicitis, ileitis and colitis) occurred in 66% of all patients, 10 (10%) had an extramesenteric form, 22 had arthritis and 6 had erythema nodosum. The mean age was 33.6 (SD 19.4) years. Abdominal pain was the syndrome most frequently observed (in 55%), followed by diarrhoea in 44% and malaise in 41%. The duration of the disease was shorter than four weeks in 37% and longer than eight weeks in 34%. Serotype 03 was most frequently isolated. The agglutination reaction was positive in 25%, false-positive in 7% and false-negative in 68%; 91% had specific IgA and IgG antibodies against two or more virulence proteins (Yops).
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PMID:[Clinical findings and diagnosis of Yersinia enterocolitica infections; a retrospective study in Friesland]. 173 36

The authors investigated the incidence of campylobacteriosis in the population of five paediatric health communities of the Jihlava policlinic (5831 children) for a period of three years. A total of 2408 specimens faeces from 1501 subjects were examined. Campylobacter jejuni was detected in 151 subjects (10.1%), Salmonella sp. in 47 (3.1%), Shigella sp. in 18 (1.2%), Yersinia enterocolitica in 12 (0.8%) and enteropathogenic Escherichia coli in five subjects (0.3%). The total incidence of campylobacteriosis in the investigated group was 863 cases per 100,000 subjects per year. The incidence of campylobacteriosis was seasonal with a maximum during the summer months. To elucidate the source of infection and way of transmission 323 smears from animals, animal products and from the environment were made. Seventy were positive. Campylobacterosis is transmitted to man most frequently by ingestion of primarily or secondarily contamined food, by contact with animals and even interhuman transmission cannot be ruled out. The most frequent clinical symptoms of campylobacteriosis were diarrhoea, fever, abdominal pain and vomiting. Seventeen children were hospitalized. For treatment most frequently Endiaron was used and dietotherapy. Campylobacteriosis affects significantly more frequently children of gipsy origin.
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PMID:[A 3-year follow-up study of the incidence of campylobacteriosis in a pediatric population]. 209 13


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